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Wu PC, Lin WC, Wang CW, Chung WH, Chen CB. Cutaneous adverse reactions associated with COVID-19 vaccines: Current evidence and potential immune mechanisms. Clin Immunol 2024; 263:110220. [PMID: 38642783 DOI: 10.1016/j.clim.2024.110220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2023] [Revised: 03/04/2024] [Accepted: 04/14/2024] [Indexed: 04/22/2024]
Abstract
As the number of vaccinated individuals has increased, there have been increasing reports of cutaneous hypersensitivity reactions. The main COVID-19 vaccines administered include messenger ribonucleic acid vaccines, non-replicating viral vector vaccines, inactivated whole-virus vaccines, and protein-based vaccines. These vaccines contain active components such as polyethylene glycol, polysorbate 80, aluminum, tromethamine, and disodium edetate dihydrate. Recent advances in understanding the coordination of inflammatory responses by specific subsets of lymphocytes have led to a new classification based on immune response patterns. We categorize these responses into four patterns: T helper (Th)1-, Th2-, Th17/22-, and Treg-polarized cutaneous inflammation after stimulation of COVID-19 vaccines. Although the association between COVID-19 vaccination and these cutaneous adverse reactions remains controversial, the occurrence of rare dermatoses and their short intervals suggest a possible relationship. Despite the potential adverse reactions, the administration of COVID-19 vaccines is crucial in the ongoing battle against severe acute respiratory syndrome coronavirus 2.
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Affiliation(s)
- Po-Chien Wu
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Wan-Chen Lin
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
| | - Chuang-Wei Wang
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Research Center of Big Data and Meta-Analysis, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China; College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Hung Chung
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan; Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan; Department of Dermatology, Beijing Tsinghua Chang Gung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China; Department of Dermatology, Ruijin Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China; Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan
| | - Chun-Bing Chen
- Department of Dermatology, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Drug Hypersensitivity Clinical and Research Center, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Cancer Vaccine and Immune Cell Therapy Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan; Chang Gung Immunology Consortium, Chang Gung Memorial Hospital, Linkou, and Chang Gung University, Taoyuan, Taiwan; Department of Dermatology, Xiamen Chang Gung Hospital, Xiamen, China; College of Medicine, Chang Gung University, Taoyuan, Taiwan; Whole-Genome Research Core Laboratory of Human Diseases, Chang Gung Memorial Hospital, Keelung, Taiwan; Immune-Oncology Center of Excellence, Chang Gung Memorial Hospital, Linkou, Taiwan; Graduate Institute of Clinical Medical Sciences, College of Medicine, Chang Gung University, Taoyuan, Taiwan; Genomic Medicine Core Laboratory, Chang Gung Memorial Hospital, Linkou, Taiwan; School of Medicine, National Tsing Hua University, Hsinchu, Taiwan.
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2
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Saleh W, Alharbi H, Cha S. Increased prevalence of erythema multiforme in patients with COVID-19 infection or vaccination. Sci Rep 2024; 14:2801. [PMID: 38307870 PMCID: PMC10837137 DOI: 10.1038/s41598-024-52099-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 01/13/2024] [Indexed: 02/04/2024] Open
Abstract
Several reports stated that erythema multiforme (EM) was associated with COVID-19 with detrimental outcomes in patients. However, since most of these are case reports, it is challenging to quantitively assess their associations. Therefore, our study aims to determine the prevalence of EM in the context of COVID-19. The study was designed as a retrospective cross-sectional hospital-based study of registered patients at the University of Florida Health Hospital. The ICD-10 codes for EM, COVID-19 infection, and COVID-19 vaccines were searched in the database. The odds ratio was calculated to assess the risk of EM after COVID-19 infection or vaccination. Our study included 43,547 patients with a history of COVID-19 infection, of whom 92 developed EM. Patients with COVID-19 infection were 6.68 times more likely to have EM than those without COVID-19 (P < 0.0001). Similarly, the risk of developing EM after COVID-19 vaccination was 2.7, significantly higher than the general population (P < 0.0001). The prevalence of EM following COVID-19 infection or vaccination significantly differs from the general population, highlighting the importance of monitoring patients for EM after COVID-19 infection and/or vaccination. It is imperative to disseminate awareness to clinicians and patients regarding the impact of COVID-19 on EM.
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Affiliation(s)
- Wafaa Saleh
- Oral Medicine, Periodontology, Diagnosis and Oral Radiology Department, Faculty of Dentistry, Mansoura University, Mansoura, 33516, Egypt.
| | - Hamad Alharbi
- Department of Oral and Maxillofacial Surgery, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Seunghee Cha
- Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL, 32610, USA
- Center for Orphaned Autoimmune Disorders (COAD), University of Florida College of Dentistry, Gainesville, FL, 32610, USA
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3
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Gubernot D, Menis M, Whitaker B. Background rates for severe cutaneous reactions in the US: Contextual support for safety assessment of COVID-19 vaccines and novel biologics. Vaccine 2023; 41:6922-6929. [PMID: 37891051 DOI: 10.1016/j.vaccine.2023.10.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 09/11/2023] [Accepted: 10/11/2023] [Indexed: 10/29/2023]
Abstract
The global COVID-19 public health crisis has resulted in extraordinary collaboration to expeditiously develop vaccines and therapeutics. The safety of these biologics is closely monitored by the US Food and Drug Administration (FDA) and the Centers for Disease Control and Prevention (CDC). Novel products may have limited safety data, and although serious medical outcomes associated with vaccination are rare, knowledge of background incidence rates of medical conditions in the US population puts reported adverse events (AEs) in perspective for further study. Although relatively minor vaccination skin reactions are common, rare instances of severe delayed hypersensitivity reactions such as erythema multiforme (EM), Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome may occur. To aid in the assessment of these events, we performed a literature search in PubMed and Web of Science on the background incidence of EM, SJS, SJS/TEN, and TEN in the US population and on published reports of these conditions occurring post-vaccination. The US background annual incidence rates per million individuals of all ages ranged from 5.3 to 63.0 for SJS, from 0.4 to 5.0 for TEN, and from 0.8 to 1.6 for SJS/TEN. Since these conditions may overlap, some studies reported rates for EM/SJS/TEN combined, however we did not find studies with exclusive EM incidence rates. The published literature, including studies of reports submitted to the FDA/CDC Vaccine Adverse Event Reporting System (VAERS), describes post-vaccination EM, SJS, SJS/TEN and/or TEN as rare occurrences. The vaccines most frequently associated with these conditions were measles, mumps, and rubella; diphtheria, tetanus, and pertussis; and varicella. The majority of VAERS reports of EM, SJS, SJS/TEN, or TEN occurred in children within 30 days of vaccination. This review summarizes background rates of these disorders in the general population and published AEs among vaccine recipients, to support safety surveillance of COVID-19 vaccines and other biologics.
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Affiliation(s)
- Diane Gubernot
- U.S. Food and Drug Administration, Center for Biologics Evaluation and Research, 10903 New Hampshire Avenue, Silver Spring, MD 20993, United States.
| | - Mikhail Menis
- U.S. Food and Drug Administration, Center for Biologics Evaluation and Research, 10903 New Hampshire Avenue, Silver Spring, MD 20993, United States.
| | - Barbee Whitaker
- U.S. Food and Drug Administration, Center for Biologics Evaluation and Research, 10903 New Hampshire Avenue, Silver Spring, MD 20993, United States.
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4
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Ryoo YW, Yun JM, Kim HW, Lee HW, Jung HR, Kim SA. Cases of Pernio-Like Lesions after mRNA-1273 Vaccination with Clinical and Pathological Features: A Single-Center Experience. Ann Dermatol 2023; 35:S281-S286. [PMID: 38061722 PMCID: PMC10727901 DOI: 10.5021/ad.21.307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 03/07/2022] [Accepted: 05/17/2022] [Indexed: 12/20/2023] Open
Abstract
The currently available coronavirus disease 2019 (COVID-19) vaccines in South Korea include mRNA (Moderna® and Pfizer®) and adenoviral vector (AstraZeneca® and Janssen®) vaccines. Dermatologic side effects of COVID-19 vaccines range from local injection site reactions to systemic eruptions, including morbilliform rashes or erythema multiforme. Pernio-like lesions, one of the most common cutaneous manifestations of COVID-19, have been rarely reported post-vaccination. Herein, we report four cases of pernio-like lesions, which were detected in a single tertiary hospital within 2 months, after the first dose of mRNA-1273 (Moderna®) vaccination was administered. In this study, we discuss the clinical and pathological features of our cases and compare them with those of previously reported cases of pernio-like lesions after COVID-19 vaccination. It is pivotal to realize that perniolike lesions can be a possible side effect of COVID-19 vaccination and that the number of patients experiencing this side effect is bound to be quite high in real-world clinical settings.
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Affiliation(s)
- Young-Wook Ryoo
- Department of Dermatology, Keimyung University School of Medicine, Daegu, Korea
| | - Ji-Min Yun
- Department of Dermatology, Keimyung University School of Medicine, Daegu, Korea
| | - Hyun-Wook Kim
- Department of Dermatology, Keimyung University School of Medicine, Daegu, Korea
| | - Hye Won Lee
- Department of Pathology, Keimyung University School of Medicine, Daegu, Korea
| | - Hye Ra Jung
- Department of Pathology, Keimyung University School of Medicine, Daegu, Korea
| | - Sung-Ae Kim
- Department of Dermatology, Keimyung University School of Medicine, Daegu, Korea.
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5
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Murata T, Nobukuni Y. Erythema Multiforme Induced by Zonisamide and Triggered by the First Dose of COVID-19 Vaccine (Pfizer-BioNTech). Am J Ther 2023; 30:e261-e265. [PMID: 37278706 DOI: 10.1097/mjt.0000000000001549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Tsukasa Murata
- Kumamoto Seimei Hospital, Kumamoto, Japan. Dr. Nobukuni is now with the Mashiki Hospital. Kamimashiki, Japan
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6
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Yousefian M, Khadivi A. Occurrence of erythema multiforme following COVID-19 vaccination: a review. Clin Exp Vaccine Res 2023; 12:87-96. [PMID: 37214146 PMCID: PMC10193109 DOI: 10.7774/cevr.2023.12.2.87] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 02/02/2023] [Indexed: 05/24/2023] Open
Abstract
The fast development of vaccines against the novel coronavirus disease is among the most critical steps taken to control this potentially fatal viral disease. Like other vaccines, the coronavirus disease 2019 (COVID-19) vaccines can also cause unwanted reactions. Erythema multiforme (EM) is among the oral mucocutaneous side effects of COVID-19 vaccines. This study aimed to comprehensively review the reported cases of EM since the global onset of COVID-19 vaccination. Data from 31 relevant studies regarding the type and dose of COVID-19 vaccines administered, time of initiation of symptoms, age, and gender of patients, site of involvement, patients' medical history, and treatment options were extracted. In total, 90 patients were identified with EM as a side effect of COVID-19 vaccination across studies. EM had the highest frequency after receiving the first dose of mRNA vaccines in older individuals. The first symptoms of EM appeared in less than 3 days in 45% and after 3 days in 55% of patients. EM is not a common side effect of COVID-19 vaccination, and fear of its occurrence should not impede vaccination.
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Affiliation(s)
- Marzieh Yousefian
- Department of Oral and Maxillofacial Medicine, School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
| | - Alireza Khadivi
- School of Dentistry, Alborz University of Medical Sciences, Karaj, Iran
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7
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Karatas E, Nazim A, Patel P, Vaidya T, Drew GS, Amin SA, Keyes AA, Fonseca M, Mir A, Halverstam CP. Erythema multiforme reactions after Pfizer/BioNTech (BNT162b2) and Moderna (mRNA-1273) COVID-19 vaccination: A case series. JAAD Case Rep 2023; 32:55-58. [PMID: 35097177 PMCID: PMC8786602 DOI: 10.1016/j.jdcr.2021.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Affiliation(s)
- Elif Karatas
- Department of Internal Medicine, Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Ali Nazim
- Ross University School of Medicine, Bridgetown, Barbados
| | - Parth Patel
- Division of Dermatology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York
| | - Toral Vaidya
- Department of Dermatology, Weill Cornell Medical College, New York, New York
| | | | | | - Ashley A. Keyes
- Department of Dermatology, Weill Cornell Medical College, New York, New York
| | - Maira Fonseca
- Department of Dermatology, Weill Cornell Medical College, New York, New York
| | - Adnan Mir
- Dermpath Diagnostics, Port Chester, New York
| | - Caroline P. Halverstam
- Division of Dermatology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York,Correspondence to: Caroline P. Halverstam, MD, Division of Dermatology, Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, 3411 Bainbridge Avenue, 2nd Floor, Bronx, NY 10467
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8
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Kowe PA, Behera B, Sethy M, Viswan P. Erythema multiforme-like reaction following COVID-19 vaccination. Indian J Dermatol Venereol Leprol 2023; 89:160. [PMID: 35962494 DOI: 10.25259/ijdvl_791_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2021] [Accepted: 04/01/2022] [Indexed: 02/03/2023]
Affiliation(s)
- Priyanka Arun Kowe
- Department of Dermatology, All India Institute of Medical Sciences, Patrapada, Bhubaneswar, Odisha, India
| | - Biswanath Behera
- Department of Dermatology, All India Institute of Medical Sciences, Patrapada, Bhubaneswar, Odisha, India
| | - Madhusmita Sethy
- Department of Pathology, All India Institute of Medical Sciences, Patrapada, Bhubaneswar, Odisha, India
| | - Parvathy Viswan
- Department of Dermatology, All India Institute of Medical Sciences, Patrapada, Bhubaneswar, Odisha, India
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9
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Washrawirul C, Triwatcharikorn J, Phannajit J, Ullman M, Susantitaphong P, Rerknimitr P. Global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination: A systematic review and meta-analysis. J Eur Acad Dermatol Venereol 2022; 36:1947-1968. [PMID: 35666609 PMCID: PMC9348179 DOI: 10.1111/jdv.18294] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Accepted: 05/18/2022] [Indexed: 01/08/2023]
Abstract
Although vaccination is widely accepted as an effective method of preventing and controlling the COVID-19 pandemic, many people are concerned about possible cutaneous side effects which can delay or prevent them from being vaccinated. The objectives of this systematic review were to assess the global prevalence and clinical manifestations of cutaneous adverse reactions following COVID-19 vaccination. PubMed and Scopus databases were searched for articles published from January 1, 2019, to December 31, 2021, and reference lists for each selected article were screened. Case reports, case series, observational studies, and randomized controlled trials that provided information on cutaneous adverse reactions following COVID-19 vaccines were included. A total of 300 studies were included in a systematic review of which 32 studies with 946,366 participants were included in the meta-analysis. The pooled prevalence of cutaneous manifestations following COVID-19 vaccination was 3.8% (95% CI, 2.7%-5.3%). COVID-19 vaccines based on the mRNA platform had a higher prevalence than other platforms at 6.9% (95% CI, 3.8%-12.3%). Various cutaneous manifestations have been reported from injection site reactions which were the most common (72.16%) to uncommon adverse reactions such as delayed inflammatory reactions to tissue filler (0.07%) and flares of pre-existing dermatoses (0.07%). Severe cutaneous reactions such as anaphylaxis have also been reported, but in rare cases (0.05%). In conclusion, cutaneous adverse reactions are common, especially in those receiving mRNA vaccines. Most reactions are mild and are not contraindications to subsequent vaccination except for anaphylaxis, which rarely occurs. COVID-19 vaccination may also be associated with flares of pre-existing dermatoses and delayed inflammatory reactions to tissue filler. Patients with a history of allergies, pre-existing skin conditions, or scheduled for filler injections should receive additional pre-counseling and monitoring. A better understanding of potential side effects may strengthen public confidence in those wary of new vaccine technologies.
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Affiliation(s)
- C Washrawirul
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - J Triwatcharikorn
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - J Phannajit
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Division of Clinical Epidemiology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - M Ullman
- Department of Research Affairs, Chulalongkorn University, Bangkok, Thailand
| | - P Susantitaphong
- Division of Nephrology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.,Research Unit for Metabolic Bone Disease in CKD Patients, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - P Rerknimitr
- Division of Dermatology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.,Skin and Allergy Research Unit, Chulalongkorn University, Bangkok, Thailand
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Abstract
We report the case of a young female adult in her early 20s, who had COVID-19 infection for 8 weeks and COVID-19 vaccination 4 weeks prior to presentation with an extensive rash associated with erythema multiforme, resembling varicella zoster on initial presentation. After initial acyclovir therapy with no improvement, systemic corticosteroid treatment dramatically resolved the patient’s skin rash.
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Affiliation(s)
- Karim Premji Manji
- Pediatrics and Child Health, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - George Mwaniki
- Family Medicine, Premier Care Clinic and Pharmacy, Dar es Salaam, Tanzania
| | - Alma Abu Simba
- History, University of Dar es Salaam, Dar es Salaam, Tanzania
| | - Julie Makani
- Haematology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
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11
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Petruzzi M, Galleggiante S, Messina S, Della Vella F. Oral erythema multiforme after Pfizer-BioNTech COVID-19 vaccination: a report of four cases. BMC Oral Health 2022; 22:90. [PMID: 35331228 PMCID: PMC8943505 DOI: 10.1186/s12903-022-02124-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Accepted: 03/16/2022] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND The 2019 Coronavirus disease (Covid-19) has affected thousands of people worldwide. To date, vaccines appear to be the only method to prevent and reduce mortality. Four vaccinations have been outwardly approved by European Medicine Agency (EMA) in Europe: BNT162b2 (Comirnaty-BioNTech/Pfizer), mRNA-1273 (Spikevax-Moderna), ChAdOx1 (VaxzevriaAstrazeneca), and Ad26.COV2-S (Janssen-Johnson&Johnson). After vaccination, local and systemic adverse effects can occur. Cutaneous reactions like urticaria, local injection site pain, morbilliform rash have been documented after vaccination. CASES PRESENTATION We report four cases of oral erythema multiforme flare arising after BNT162b2 vaccination administration. All the patients denied previous erythema-like and herpetic manifestations history. Two of the reported cases (number 1 and 2) presented with both oral and cutaneous lesions, while cases 3 and 4 showed only oral manifestations. Three of the cases presented the erythema after the first vaccination dosage administration, only one case reported lesions after the second vaccination dosage administration. All the cases were treated with prednisone via oral administration and topical 0.05% clobetasol ointment. CONCLUSIONS The present reports represent some of the few cases of erythema multiforme occurring as a side effect of the BNT162b2 COVID-19 vaccination. The causal role of the vaccine for the erythema multiforme has not been proven yet; nevertheless, it is not uncommon for medications to trigger this disease. The vaccine could surface a silent herpes virus infection, which would induce the erythema multiforme instead.
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Affiliation(s)
- Massimo Petruzzi
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy.,Department of Restorative, Preventive and Pediatric Dentistry, University of Bern, Bern, Switzerland
| | - Sara Galleggiante
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Sabrina Messina
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy
| | - Fedora Della Vella
- Interdisciplinary Department of Medicine, University of Bari "Aldo Moro", Bari, Italy.
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12
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Kroumpouzos G, Paroikaki ME, Yumeen S, Bhargava S, Mylonakis E. Cutaneous Complications of mRNA and AZD1222 COVID-19 Vaccines: A Worldwide Review. Microorganisms 2022; 10:624. [PMID: 35336199 PMCID: PMC8953728 DOI: 10.3390/microorganisms10030624] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 01/07/2022] [Accepted: 03/09/2022] [Indexed: 02/07/2023] Open
Abstract
Because of the increasing emergence of cutaneous reactions from COVID-19 vaccines worldwide, we investigated the published reports of these complications. We searched the PubMed, Google Scholar, and Scopus databases and the preprint server bioRxiv for articles on cutaneous complications linked to mRNA-1273 (Moderna), BNT162b2 (Pfizer–BioNTech), and AZD1222 (AstraZeneca–Oxford University) vaccines published until 30 September 2021. Eighty studies describing a total of 1415 reactions were included. Cutaneous reactions were more prevalent in females (81.6%). Delayed large local reactions were the most common complication (40.4%), followed by local injection site reactions (16.5%), zoster (9.5%), and urticarial eruptions (9.0%). Injection site and delayed large local reactions were predominantly caused by the mRNA-1273 vaccine (79.5% and 72.0%, respectively). BNT162b2 vaccination was more closely linked to distant reactions (50.1%) than mRNA-1273 (30.0%). Zoster was the most common distant reaction. Of reactions with adequate information for both vaccine doses, 58.3% occurred after the first dose only, 26.9% after the second dose only, and 14.8% after both doses. Overall, a large spectrum of cutaneous reaction patterns occurred following the COVID-19 vaccination. Most were mild and without long-term health implications. Therefore, the occurrence of such dermatologic complications does not contraindicate subsequent vaccination.
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13
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Ben Salem C, Khelif A, Sahnoun D, Ghariani N, Sriha B, Denguezli M. Another case of generalized bullous fixed drug eruption following an adenoviral-vector based Covid-19 vaccine (ChAdOx1 nCov-19). J Eur Acad Dermatol Venereol 2022; 36:e516-e517. [PMID: 35274363 PMCID: PMC9114837 DOI: 10.1111/jdv.18059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 02/07/2022] [Accepted: 03/04/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Chaker Ben Salem
- Pharmacovigilance Center of Sousse, University of Sousse, Tunisia
| | | | - Dhouha Sahnoun
- Pharmacovigilance Center of Sousse, University of Sousse, Tunisia
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14
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Avallone G, Quaglino P, Cavallo F, Roccuzzo G, Ribero S, Zalaudek I, Conforti C. SARS-CoV-2 vaccine-related cutaneous manifestations: a systematic review. Int J Dermatol 2022; 61:1187-1204. [PMID: 35141881 PMCID: PMC9111829 DOI: 10.1111/ijd.16063] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Revised: 12/10/2021] [Accepted: 12/30/2021] [Indexed: 12/14/2022]
Abstract
To date, over 250 million people have been reportedly infected by COVID‐19 disease, which has spread across the globe and led to approximately 5.1 million fatalities. To prevent both COVID‐19 and viral transmission, DNA‐based/RNA‐based vaccines, non‐replicating viral vector vaccines, and inactivated vaccines have been recently developed. However, a precise clinical and histological characterization of SARS‐CoV‐2 vaccine‐related dermatological manifestations is still lacking. A systematic review of 229 articles was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines, in order to provide an extensive overview of SARS‐CoV‐2 vaccine‐related skin manifestations. Data on demographics, number of reported cases with cutaneous involvement, vaccine, and rash type (morphology) were extracted from articles and summarized. A total of 5941 SARS‐CoV‐2 vaccine‐related dermatological manifestations were gathered. Local injection‐site reactions were the most frequently observed, followed by rash/unspecified cutaneous eruption, urticarial rashes, angioedema, herpes zoster, morbilliform/maculopapular/erythematous macular eruption, pityriasis rosea and pityriasis rosea‐like eruptions, and other less common dermatological manifestations. Flares of pre‐existing dermatological conditions were also reported. Cutaneous adverse reactions following SARS‐CoV‐2 vaccine administration seem to be heterogeneous, rather infrequent, and not life‐threatening. Vaccinated patients should be monitored for skin manifestations, and dermatological evaluation should be offered, when needed.
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Affiliation(s)
- Gianluca Avallone
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Pietro Quaglino
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Francesco Cavallo
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Gabriele Roccuzzo
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Simone Ribero
- Dermatology Clinic, Department of Medical Sciences University of Turin, Turin, Italy
| | - Iris Zalaudek
- Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy
| | - Claudio Conforti
- Dermatology Clinic, Maggiore Hospital of Trieste, Trieste, Italy
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15
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Abstract
Background The increasing number of reports on cutaneous reactions following COVID-19 vaccination has led to growing concerns among certain groups. Objective We reviewed the published reports of cutaneous lesions after COVID-19 vaccination. Methods We conducted a literature search for original and review articles published between January 1, 2020, and September 27, 2021. Results Eleven cutaneous reactions associated with COVID-19 vaccines were determined; the most prevalent reactions were local injection site reactions, delayed local reactions, urticaria, angioedema, and morbilliform eruptions. There were more reports on skin reactions following the administration of messenger RNA-based vaccines than on those following the administration of adenoviral vector or inactivated whole-virus vaccines, in part, due to their higher administration rate. Most reported skin reactions occurred after the first vaccine dose. Limitations A reporting bias could not be excluded, and skin biopsy results were not available for most included individuals. Moreover, given that the included trials focused on vaccine efficacy, there was a lack of details concerning cutaneous reactions and participant information. Conclusion Not all cutaneous reactions observed after COVID-19 vaccination are hypersensitivity reactions. Different cutaneous reactions may reflect underlying immune responses to the vaccines. A large majority of COVID-19 vaccination reactions were mild and self-limiting, and people should be encouraged to complete their vaccination regimen.
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16
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Borg L, Mercieca L, Mintoff D, Micallef D, Pisani D, Betts A, Scerri L. Pfizer-BioNTech SARS-CoV-2 mRNA vaccine-associated erythema multiforme. J Eur Acad Dermatol Venereol 2022; 36:e22-e24. [PMID: 34547125 DOI: 10.1111/jdv.17682] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 09/16/2021] [Indexed: 11/30/2022]
Affiliation(s)
- L Borg
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - L Mercieca
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - D Mintoff
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - D Micallef
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
| | - D Pisani
- Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - A Betts
- Department of Pathology, Mater Dei Hospital, Msida, Malta
| | - L Scerri
- Department of Dermatology, Mater Dei Hospital, Msida, Malta
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17
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Burlando M, Herzum A, Micalizzi C, Cozzani E, Parodi A. Cutaneous reactions to COVID-19 vaccine at the dermatology primary care. Immun Inflamm Dis 2021; 10:265-271. [PMID: 34837354 PMCID: PMC8767505 DOI: 10.1002/iid3.568] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Revised: 11/05/2021] [Accepted: 11/09/2021] [Indexed: 12/15/2022] Open
Abstract
Introduction Coronavirus disease 2019 (COVID‐19) vaccines can cause adverse reactions, mainly from vaccine‐induced immune responses. Some of these may also involve the skin and worry unaware patients. A better understanding of such adverse reactions may reduce concerns and help promote the vaccination of large population groups. Methods All the reports of patients admitted to our Dermatology Primary Care, from March 2021 to June 2021, were retrospectively examined to collect descriptive data on skin reactions arising after COVID‐19 vaccination. Results Out of 200 vaccinated patients admitted to the Dermatology Primary Care, 21 (10.5%) referred cutaneous reactions with onset after vaccination. Only one patient required hospitalization for generalized bullous erythema multiforme, which occurred 48 h after the second vaccine dose. The other patients' cutaneous reactions to vaccination were of mild/moderate degree. Three patients presented exacerbation of their cutaneous diseases. Conclusions Cutaneous reactions observed in our sample were mostly mild or moderate. Awareness must be raised to recognize and treat eventual severe reactions. Future studies are needed to assess the incidence of cutaneous reactions following COVID‐19 vaccination.
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Affiliation(s)
- Martina Burlando
- Department of Health Sciences (DISSAL), Section of Dermatology, San Martino Polyclinic Hospital IRCCS, Largo R, University of Genova, Genova, Italy
| | - Astrid Herzum
- Department of Health Sciences (DISSAL), Section of Dermatology, San Martino Polyclinic Hospital IRCCS, Largo R, University of Genova, Genova, Italy
| | - Claudia Micalizzi
- Department of Health Sciences (DISSAL), Section of Dermatology, San Martino Polyclinic Hospital IRCCS, Largo R, University of Genova, Genova, Italy
| | - Emanuele Cozzani
- Department of Health Sciences (DISSAL), Section of Dermatology, San Martino Polyclinic Hospital IRCCS, Largo R, University of Genova, Genova, Italy
| | - Aurora Parodi
- Department of Health Sciences (DISSAL), Section of Dermatology, San Martino Polyclinic Hospital IRCCS, Largo R, University of Genova, Genova, Italy
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18
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Iwasawa O, Kamiya K, Komine M, Ohtsuki M. Case of atypical erythema multiforme following coronavirus disease 2019 vaccination. J Dermatol 2021; 49:e113-e114. [PMID: 34821413 DOI: 10.1111/1346-8138.16255] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 11/04/2021] [Accepted: 11/16/2021] [Indexed: 12/25/2022]
Affiliation(s)
- Okuto Iwasawa
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | - Koji Kamiya
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | - Mayumi Komine
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
| | - Mamitaro Ohtsuki
- Department of Dermatology, Jichi Medical University, Shimotsuke, Japan
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19
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Abstract
Despite the growing availability of coronavirus disease 2019 (COVID-19) vaccines in the general population, a significant proportion of individuals demonstrate vaccine hesitancy. We sought to consolidate and update current evidence on cutaneous adverse events from COVID-19 vaccines to aid in the education and counseling of patients concerned about potential cutaneous side effects. We conducted a literature review of PubMed in May 2021 to identify reports of cutaneous events after vaccination with the Pfizer-BioNTech and Moderna vaccines (postauthorization clinical reports pertaining to the Johnson & Johnson and AstraZeneca vaccines were limited). Event reports in the Vaccine Adverse Event Reporting System were reviewed. Localized cutaneous reactions were common after the mRNA vaccines, consistent with clinical trial findings. Reported urticarial and morbilliform eruptions may reflect immediate hypersensitivity but have rarely been associated with anaphylaxis. There are infrequent reports of herpes zoster, dermatologic filler reactions, and immune thrombocytopenia, mainly occurring in high-risk patient groups. Ultimately, the identified cutaneous reactions are largely self-limited and should not discourage vaccination. Existing reports should reassure patients of the overall compelling safety profiles of the mRNA COVID-19 vaccines and benignity of skin reactions after vaccination.
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Affiliation(s)
- Christian Gronbeck
- University of Connecticut School of Medicine, Farmington, Connecticut, USA
| | - Jane M Grant-Kels
- Department of Dermatology, University of Connecticut School of Medicine, Farmington, Connecticut, USA.
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20
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Jeon YH, Lim DH, Choi SW, Choi SJ. A flare of Still's disease following COVID-19 vaccination in a 34-year-old patient. Rheumatol Int 2021. [PMID: 34797392 DOI: 10.1007/s00296-021-05052-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Accepted: 11/06/2021] [Indexed: 01/05/2023]
Abstract
Vaccination is a cornerstone for reducing the risk of COVID-19 infection during a pandemic. Although the currently used COVID-19 vaccine is considered safe, some concerns persist regarding the likelihood of flares of rheumatic diseases. Still’s disease is a rare auto-inflammatory disorder of unknown etiology, and the data on the flare of Still’s disease following COVID-19 vaccination are limited. Therefore, we hereby present the case of a 34-year-old female patient with Still’s disease who experienced a flare after a ChAdOx1 nCoV-19 vaccination. The patient visited the emergency department complaining of fever, arthralgia, myalgia, pleuritic chest pain and macular salmon-pink rash on her back for the past 2 days. She had maintained low Still’s disease activity with etanercept and low-dose glucocorticoid for 14 years. She received the ChAdOx1 nCoV-19 vaccine 7 days before the flare. Laboratory investigations revealed leucocytosis and elevated serum levels of erythrocyte sedimentation rate, C-reactive protein, and ferritin. Computed tomography showed no specific findings. She received methylprednisolone pulse therapy, etanercept, and methotrexate for treating the Still’s disease flare. However, her symptoms were not fully controlled, and she developed pericarditis, pleuritis, fever and macular rashes expanding to her extremities. After excluding infectious conditions by blood culture and pleural fluid analysis, we administered tocilizumab with methotrexate and prednisolone. Her symptoms and laboratory findings improved significantly, and she was discharged without symptoms 7 days later. Although rare, this case of a patient with Still’s disease undergoing a flare following vaccination suggests that close observation of disease activity is warranted following COVID-19 vaccination.
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21
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Bellinato F, Maurelli M, Gisondi P, Girolomoni G. Cutaneous Adverse Reactions Associated with SARS-CoV-2 Vaccines. J Clin Med 2021; 10:5344. [PMID: 34830627 DOI: 10.3390/jcm10225344] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/11/2021] [Accepted: 11/13/2021] [Indexed: 12/19/2022] Open
Abstract
Many patients are receiving SARS-CoV-2 vaccinations, which have been associated with a variety of adverse effects. Cutaneous adverse reactions to SARS-CoV-2 vaccinations have been progressively reported, but they have not been reviewed according to their morphological clinical patterns. The objective of this review was to summarize the existing data concerning the cutaneous adverse reactions following SARS-CoV-2 vaccines and group them according to common morphological and pathogenetic patterns. We reviewed the English language literature up to 15 August 2021, using predefined keywords to identify the relevant studies evaluating cutaneous adverse reactions associated with SARS-CoV-2 vaccines. We search for recurrent morphological patterns sharing clinical signs and symptoms and physio-pathological mechanisms. Timing to onset following the first or booster dose of the vaccine, predisposing conditions, therapeutic management, and outcome were also collected. Among the dermatological manifestations associated with SARS-CoV-2 vaccinations, we distinguished: (1) new onset reactions and (2) flares of preexisting dermatoses. The most common were injection site reactions, affecting 30–70% and generally mild or moderate. Small case series or single case reports included filler reactions, exanthemas, vascular lesions, urticaria, eczematous dermatitis, autoimmune bullous reactions, and severe cutaneous adverse reactions. In addition, the exacerbation of chronic immuno-mediated dermatoses (mainly psoriasis and atopic dermatitis) and reactivations of herpes infection were reported. The cutaneous reactions were generally mild, self-limiting, and resembled common cutaneous drug eruptions and/or COVID-19 skin manifestations.
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22
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Balogun M, Millette D, Yip V, Chan SA, Lee P, Gamal N, Hashim N, Phillips D, Walsh M, Trehan P, Hanna-Bashara L, Abdullah A, Wernham A, Tso S. Phenotypic spectrum of serious cutaneous-only adverse event following immunization with COVID-19 vaccines: a multicentre case series and literature review. Clin Exp Dermatol 2021; 47:614-616. [PMID: 34748655 PMCID: PMC8653198 DOI: 10.1111/ced.15003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 11/04/2021] [Indexed: 01/26/2023]
Affiliation(s)
- M Balogun
- Birmingham Skin Centre, Sandwell and West Birmingham NHS Foundation Trust, Birmingham, UK
| | - D Millette
- Department of Dermatology, The Dudley Group NHS Foundation Trust, Dudley, UK
| | - V Yip
- Department of Dermatology, Liverpool University Hospitals, NHS Foundation Trust, Liverpool, UK
| | - S A Chan
- Birmingham Skin Centre, Sandwell and West Birmingham NHS Foundation Trust, Birmingham, UK
| | - P Lee
- Birmingham Skin Centre, Sandwell and West Birmingham NHS Foundation Trust, Birmingham, UK
| | - N Gamal
- Dermatology, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt
| | - N Hashim
- Department of Dermatology, Clatterbridge Hospital, Wirral University Teaching Hospital NHS Foundation Trust, Bebington, UK
| | - D Phillips
- Department of Dermatology, Clatterbridge Hospital, Wirral University Teaching Hospital NHS Foundation Trust, Bebington, UK
| | - M Walsh
- Department of Dermatology, St Helens and Knowsley NHS Foundation Trust, Prescot, UK
| | - P Trehan
- Department of Dermatology, St Helens and Knowsley NHS Foundation Trust, Prescot, UK
| | - L Hanna-Bashara
- Department of Dermatology, St Helens and Knowsley NHS Foundation Trust, Prescot, UK
| | - A Abdullah
- Department of Dermatology, The Dudley Group NHS Foundation Trust, Dudley, UK
| | - A Wernham
- Department of Dermatology, Walsall Healthcare NHS Foundation Trust, Walsall, UK
| | - S Tso
- Jephson Dermatology Centre, South Warwickshire NHS Foundation Trust, Warwick, UK
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23
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Gambichler T, Boms S, Susok L, Dickel H, Finis C, Abu Rached N, Barras M, Stücker M, Kasakovski D. Cutaneous findings following COVID-19 vaccination: review of world literature and own experience. J Eur Acad Dermatol Venereol 2021; 36:172-180. [PMID: 34661927 PMCID: PMC8656409 DOI: 10.1111/jdv.17744] [Citation(s) in RCA: 124] [Impact Index Per Article: 41.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 09/29/2021] [Indexed: 12/11/2022]
Abstract
There is growing evidence that not only the novel coronavirus disease (COVID‐19) but also the COVID‐19 vaccines can cause a variety of skin reactions. In this review article, we provide a brief overview on cutaneous findings that have been observed since the emerging mass COVID‐19 vaccination campaigns all over the world. Unspecific injection‐site reactions very early occurring after the vaccination are most frequent. Type I hypersensitivity reactions (e.g. urticaria, angio‐oedema and anaphylaxis) likely due to allergy to ingredients may rarely occur but can be severe. Type IV hypersensitivity reactions may be observed, including delayed large local skin lesions (“COVID arm”), inflammatory reactions in dermal filler or previous radiation sites or even old BCG scars, and more commonly morbilliform and erythema multiforme‐like rashes. Autoimmune‐mediated skin findings after COVID‐19 vaccination include leucocytoclastic vasculitis, lupus erythematosus and immune thrombocytopenia. Functional angiopathies (chilblain‐like lesions, erythromelalgia) may also be observed. Pityriasis rosea‐like rashes and reactivation of herpes zoster have also been reported after COVID‐19 vaccination. In conclusion, there are numerous cutaneous reaction patterns that may occur following COVID‐19 vaccination, whereby many of these skin findings are of immunological/autoimmunological nature. Importantly, molecular mimicry exists between SARS‐CoV‐2 (e.g. the spike‐protein sequences used to design the vaccines) and human components and may thus explain some COVID‐19 pathologies as well as adverse skin reactions to COVID‐19 vaccinations. Linked Commentary: P. Gisondi et al. J Eur Acad Dermatol Venereol 2022; 36: 165–166. https://doi.org/10.1111/jdv.17854.
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Affiliation(s)
- T Gambichler
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany.,Department of Dermatology, Christian Hospital Unna, Unna, Germany
| | - S Boms
- Department of Dermatology, Christian Hospital Unna, Unna, Germany
| | - L Susok
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - H Dickel
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - C Finis
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - N Abu Rached
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M Barras
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - M Stücker
- Department of Dermatology, Ruhr-University Bochum, Bochum, Germany
| | - D Kasakovski
- European Center for Angioscience (ECAS), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.,Division of Vascular Oncology and Metastasis, German Cancer Research Center Heidelberg (DKFZ-ZMBH Alliance), Heidelberg, Germany
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24
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Kim MJ, Kim JW, Kim MS, Choi SY, Na JI. Generalized erythema multiforme-like skin rash following the first dose of COVID-19 vaccine (Pfizer-BioNTech). J Eur Acad Dermatol Venereol 2021; 36:e98-e100. [PMID: 34661942 PMCID: PMC8656619 DOI: 10.1111/jdv.17757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2021] [Accepted: 10/13/2021] [Indexed: 12/18/2022]
Affiliation(s)
- M J Kim
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Korea
| | - J W Kim
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Korea
| | - M S Kim
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Korea
| | - S Y Choi
- Department of Dermatology, Ilsan Paik Hospital, Inje University, 170, Juhwa-ro, Ilsanseo-gu, Goyang-si, Gyeonggi-do, Korea
| | - J I Na
- Department of Dermatology, Seoul National University Bundang Hospital, 82 Gumi-ro 173 Beon-gil, Bundang-gu, Seongnam-si, Gyeonggi-do, 13620, Korea
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25
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Buján Bonino C, Moreiras Arias N, López-Pardo Rico M, Pita da Veiga Seijo G, Rosón López E, Suárez Peñaranda JM, Sánchez-Aguilar Rojas D. Atypical erythema multiforme related to BNT162b2 (Pfizer-BioNTech) COVID-19 vaccine. Int J Dermatol 2021; 60:e466-e467. [PMID: 34473839 PMCID: PMC8652986 DOI: 10.1111/ijd.15894] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/12/2021] [Accepted: 08/16/2021] [Indexed: 12/22/2022]
Affiliation(s)
- Cecilia Buján Bonino
- Department of Dermatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - Noelia Moreiras Arias
- Department of Dermatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | - María López-Pardo Rico
- Department of Dermatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
| | | | - Elena Rosón López
- Department of Dermatology, University Hospital of Santiago de Compostela, Santiago de Compostela, Spain
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26
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Falkenhain-López D, Gutiérrez-Collar C, Arroyo-Andrés J, Gallego-Gutiérrez I, Rodríguez-Peralto JL, Sánchez-Velázquez A. Widespread purpura annularis telangiectodes following mRNA SARS-CoV-2 vaccine. J Eur Acad Dermatol Venereol 2021; 35:e719-e721. [PMID: 34236717 PMCID: PMC8447368 DOI: 10.1111/jdv.17497] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- D Falkenhain-López
- Dermatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - C Gutiérrez-Collar
- Dermatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
| | - J Arroyo-Andrés
- Dermatology Department, Hospital Universitario 12 de Octubre, Madrid, Spain
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27
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Ayatollahi A, Hosseini H, Firooz R, Firooz A. COVID-19 vaccines: What dermatologists should know? Dermatol Ther 2021; 34:e15056. [PMID: 34232548 PMCID: PMC8420198 DOI: 10.1111/dth.15056] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/30/2021] [Accepted: 07/05/2021] [Indexed: 12/12/2022]
Abstract
As COVID‐19 vaccination has started worldwide to control this pandemic, dermatologists may face various challenges with these new vaccines. In this manuscript, we review different types of available COVID‐19 vaccines and their various production platforms. Vaccination considerations in patients with skin diseases, especially those using immunomodulatory drugs will be presented. Finally, adverse cutaneous reactions of COVID‐19 vaccines will be reviewed.
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Affiliation(s)
- Azin Ayatollahi
- Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamed Hosseini
- Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Rojin Firooz
- Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Firooz
- Center for Research & Training in Skin Diseases & Leprosy, Tehran University of Medical Sciences, Tehran, Iran
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